Learning disorders

The first step in treating a learning disorder is forming a complete and accurate diagnosis. Here at Children’s Hospital Boston, whether your child is seen in the Learning Disorders Program or the Developmental Medicine Center, he’ll be evaluated by a range of specialists and sub-specialists who will work together to determine his complete cognitive profile and how he learns best.

While each child is different, our evaluations are often aimed at addressing the following questions:

• What is the nature of the child's problem?
• Is there a medical basis for the child's problems?
• Are emotional or social factors impeding the learning progress?
• Is the learning problem causing emotional or social problems?
• What are the best ways to address learning and development in terms of programs and specific interventions?

Most of what we do in the course of an evaluation falls under one of three categories: make or clarify a diagnosis, assess current functioning and make recommendations based on the child’s strengths and weaknesses.

1. Make or clarify a diagnosis

If a child is having difficulty in school, it’s not always clear why. For example, if he doesn’t seem to be paying attention, the cause could be:

• medical, e.g., if a child has sleep apnea, he could be too tired in class to pay attention.
• behavioral or psychological, e.g.the child may have difficulty concentrating because of ADHD or a similar condition.
• a learning disorder, e.g. the child may have stopped paying attention to a lesson because it’s moving too quickly or being delivered in a way that he has challenges with.
   

Our interdisciplinary evaluation allows us to not only understand the nature of your child’s challenges, but also to tease out the specifics and identify any underlying problems—resulting in a custom-tailored plan for academic/social/behavioral success, depending on your child’s needs.

Components of your child’s evaluation may include:  

• a thorough medical exam, including vision and hearing tests
• a complete medical history
• a social history
• a developmental exam
• a motor exam
• a neurological exam
• a psychological exam
   

2. Assess current functioning

Depending on your child’s age, we’ll also play with him or ask him to complete tests aimed at gaining a deep cognitive/intellectual assessment of his current abilities. Are they at the level at which we might expect him to perform?

Again, depending on age and circumstance, we may look at his:

• social and emotional functioning
• verbal language skills
• executive functioning, including memory skills
• mathematics skills
• reading skills (word-decoding, comprehension, vocabulary)
   

For younger children, we look for risk factors and precursors to learning disorders.
 

3. Recommendations in light of child’s strengths and weaknesses.

After our experts have met with your child, they convene for a team conference to discuss all of the results. Within a couple of weeks, we invite you back to Children’s for a feedback session, in which we review our findings and share our medical, psychological and educational recommendations (as your child’s situation warrants). We provide you with a comprehensive report detailing these findings and recommendations, and we can also direct you to other sources of support.

If your child is older, and has had some academic experience, we’ll recommend concrete measures that can help him succeed. If your child is younger, we’ll form a hypothesis around what his vulnerable areas may be, and what types of support may be helpful going forward.
 

Q: Does my child need to have all components of the evaluation?
A: One strength of our programs is the deep and nuanced understanding our multidisciplinary approach provides—that’s why all children must participate in all components of the evaluation.
 

Q: What should I tell my child about the evaluation process?
A: This also depends on age. If your child is in pre-school, you can say that you’re coming to Children’s Hospital Boston to meet some nice people who will talk to him and ask him some questions. There will be no shots, and nothing will hurt.

Kids in pre-school might be told that they’re coming here so we can figure out how they learn best. You might add that they’ll be doing some simple tests.

Older children are generally aware of why they’re coming, and for them it’s important to stress that the visit isn’t about “what’s wrong with them” but “how can we help?”
 

Young Men’s Health Site and Center for Young Women’s Health

Why are my friendships changing?  How can I convince my parents that being a vegetarian is healthy and right for me? What types of birth control are available to me, and how do I use them? Young men and young women may have some concerns specific to their gender, and some that they share. At Children’s, the Center for Young Women’s Healthand Young Men’s Health Siteoffer the latest general and gender-specific information about issues including fitness and nutrition, sexuality and health, health and development and emotional health.